Pulmonary artery aneurysm (PAA) may be associated with congenital shunt disease such as patent ductus arteriosus, and its frequency and management are often controversial. We report successful surgical treatment of PAA following an operation for atrial septal defect (ASD). The patient was a 47-year-old woman who underwent closure of ASD at the age of 9. When she was investigated because of thyroid tumor, enlargement of her main pulmonary artery was pointed out and she was admitted to our hospital. Several examinations revealed a diagnosis of pulmonary valve insufficiency and 70mm PAA with dilatation extending to both proximal arteries. We performed replacements of pulmonary valve and pulmonary artery with a bioprosthetic valve and T-shaped graft. The patient is doing well 2 years after operation.

Retrograde cardioplegia is now an alternative or adjunctive method used worldwide as a cardiac protection during open heart surgery. However, its use involves some limitation. We operated on a patient suffering from aortic stenosis associated with PLSVC. During the operation on this patient for aortic valve replacement, retrograde infusion of cardioplegic solution could not be performed because the coronary sinus was excessively dilated and prevented the balloon from occluding it. Other anomalous lesion of the coronary sinus make the retrograde infusion of the cardioplegic solution difficult and these must always be kept in mind when cardioplegia is infused from the coronary sinus.

OBJECTIVESThe aim of this study was to compare attitudes toward medication and associated factors for patients with schizophrenia in Japan and China.

METHODSAge-group matched samples were drawn from outpatients in Tokyo (N = 76) and Beijing (N = 76) according to the same inclusion/exclusion criteria. Psychotropic prescription and attitudes toward medication were measured using Drug Attitude Inventory-30 (DAI-30) and an original questionnaire regarding beliefs about psychiatric medication. Stepwise regression analysis of the DAI-30 data was performed for each group.

RESULTSJapanese subjects were prescribed significantly larger amounts of antipsychotics. Polypharmacy of antipsychotics and concurrent use of anticholinergics, anxiolytics, or hypnotics were more frequently found among subjects in Tokyo than among those in Beijing. However, subjects in Tokyo and Beijing had similar subjective responses to medication, subjective evaluation of side-effects, and complaints about overuse of psychotropics. Subjects in Tokyo complained less about physician's over-reliance on medication and were less concerned about medication cost than those in Beijing. In Tokyo, longer duration of illness and lower subjective distress caused by side effects predicted a more positive subjective response, while female gender, younger age, and lower Brief Psychiatric Rating Scale score were independently correlated with a better subjective response in Beijing.

CONCLUSIONSSubjective acceptance of multiple medications is greater for patients in Japan than those in China. Determinants of subjective response to medication varied between Japan and China.